Soft tissue sarcomas (STS) are a rare a highly heterogeneous set of malignant mesenchymal neoplasms. Histological grading plays a central role in the assessment and management of patients with STS, since histological gradeis prognostic, contributes to clinical staging, and is also predictive of chemotherapy responses so drives clinical decisionmaking on the use of adjuvant chemotherapy. Here we review the main histopathological grading systems andthe main considerations for the practising pathologist when grading STS. We highlight that histological STS gradingis not without its limitations, not least in classifying 50% of tumours as of uncertain behaviour (grade 2). However, recent developments in molecular risk stratification hold promise for molecular grading of STS with the ultimate goal of personalising therapy based on molecular profiles.

Breast spindle cell lesions (BCSLs) are a highly heterogenous group of diseases that frequently challenge the diagnostic skills of even specialist breast pathologists. While a systematic morphological assessment remains central to narrowing the differential diagnosis, immunohistochemistry (IHC) is a valuable ancillary test that can help to either further narrow or confirm a diagnosis. However, BSCLs can also show a remarkable degree of intra-tumoural morphological and immunohistochemical heterogeneity, meaning that IHC is rarely either specific or sensitive for a particular lesion and that care must be taken when interpreting diagnostic core biopsies. IHC results must, therefore, always be interpreted with caution and in the context of the morphological features and wider clinicopathological findings.

The Cestodes, Echinococcus granulosusand Echinococcus multilocularis are the causative agents of hydatid disease. Dog is the definitive host while humans are accidental intermediate hosts. The liver and lungs are commonly affected though other exotic sites can also be uncommonly affected. This is of great clinical relevance because of the risk of anaphylaxis during inadvertent surgical exploration or other invasive procedures. Imaging and hydatid serology (Indirect Hemagglutination, Immunoelectrophoresis, ELISA and Western Blot) are the key to pre-operative diagnosis. We present a series of hydatid cysts presenting at unusual sites including kidney, parotid, and ovary and limb muscle. Hydatid cyst should be suspected in the differential diagnosis of any cystic lesion particularly in endemic areas.

Introduction: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infection (OIs) in AIDS patients is due to viral cytopathology and are secondary to the failure of both cellular and humeral response with CD4 count of <200 mm3 leads to morbidity and mortality. Material and Methods: This is a descriptive and analytical study. Incidence of clinically and laboratory confirmed cases of opportunistic infections in HIV patients are recorded, during the one year period from June 2017- May 2018. Samples of these patients processed for CD4 counts, to assess the immune status. Results: 500 HIV seropositive patients with OI were studied. Out of these 308 (61.6%) patients had bacterial infections, of which TB (56%) was predominant infection with CD4 count <200mm3. 85 (17%) patients had viral infections, of which common was Herpes zoster 72 (14.4%). 65 (13%) patients had fungal infections of which common was oral candidiasis 46 (9.2%) with CD4 count <100 mm3. 42 (8.4%) patients had parasitic infections, of which common was chronic diarrhea 40 (8%) with CD4 count <100mm3. Commonly observed risk group was in heterosexual group (86.8%). Conclusion: Our study helps the programme manager to plan appropriate strategies for the investigation and treatment of common OIs as a part of management programme for HIV infected populations. It helps them for early diagnosis and manage the patients

Body fluids like pleural, ascetic/ peritoneal, synovial and cerebrospinal fluids are usually sterile, but they can get infected by different microbes, thus leading to life threatening infections. This study was aimed to identify the prevalence of common bacterial isolates in effusions; determine the antimicrobial susceptibility pattern; correlate the microbiological and cytological imprints of effusions. This is a cross sectional and prospective study conducted between January and December 2018 in a tertiary care teaching hospital among the samples received for pathological and microbiological investigations. Of the 267 different body fluids samples processed, 127 (47.6%) were found to have inflammatory cells, 98 (36.7%) with non infectious cells and 42 (15.7%) with malignant cells in cytology. Of the 127 inflammatory samples, 42 samples supported with bacterial growth. The most common pathogens isolated were Klebsiella pneumoniae (n=12;28.6%) followed by non fermenting gram negative bacilli, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and coagulase negative staphylococci. The gram negative isolates were relatively resistant to cephalosporins and quinolones; whereas gram positive isolates resistant to quinolones and aminoglycosides. Knowledge of the cytological investigations, bacteriological and antimicrobial resistant profile of sterile body fluids is necessary for clinicians for appropriate patient management.

The cervix is the most common site for genital tract infections and a target for viral, chemical carcinogens, which leads to invasive carcinoma. Infections are the most common complaints in gynecological practice. With the advent of new drugs for infectious diseases, the emphasis has moved to chronic diseases such as malignant diseases which are becoming important cause of death. The objective of this study was to compare the visual inspection of acetic acid test qualities with Pap smear and biopsy. Out of 500 cases, majority of the cases (232) were Negative for Intra-epithelial lesion or malignancy (NILM), 126 cases were normal smears, 16 cases were Atypical Squamous Cells of Undetermined Significance (ASCUS), 75 cases were Low-grade Squamous Intra-epithelial Lesion (LSIL), 37 cases were High-grade Squamous Intra-epithelial Lesion (HSIL), 14 were carcinoma of the cervix. Pap smears are required not only for the diagnosis and management of the malignant lesions but it is also helpful in identifying the infectious etiologies and treatment in developing countries. They need to be correlated with histopathology for further management. In developing countries, where it is not feasible to introduce pap smear screening of acceptable quality, VIA is alternative low cost method for cervical screening.

Lymphadenopathy is the most common presentation in the head and neck region and may occur due to inflammatory conditions, as well as primary and secondary neoplasms. An early and accurate diagnosis helps the clinicians in starting the specific therapy on time, thus reducing morbidity and mortality. The present study was undertaken to know the spectrum of lesions found in the Enlarged cervical lymph nodes in 628 patients. Cervical group of lymph nodes are the most common lymph nodes involved in head and neck region. Non-specific reactive lymphadenitis is the most common benign pathology associated with enlarged lymph nodes whereas metastasis is the most common malignant condition. Most common age group of enlarged lymph nodes in benign category was 3rd decade and in malignant category was 6th decade. The sensitivity and specificity of FNAC is fare enough with lot of various other advantages like rapid diagnosis, reliable, less traumatic, minimal complication, repeatability, economical and convenient. Fine needle aspiration cytology in our experience provides a reliable method of investigating lymph node enlargement, the efficacy of which approaches that of other similar diagnostic procedures and in the present study, over all accuracy and sensitivity was 94.8% and100% respectively.

Histiocytic Sarcoma (HS) is an extremely rare tumor with aggressive course and arises in lymph nodes and extra nodal sites. We present a case of HS in a 97-year-old male patient with non-specific clinical features. CT scan revealed left axillary lymph node enlargement and a hypo dense lesion in spleen. On Lymph node biopsy, a diagnosis of HS was made based on the histomorphology and immunopositivity of tumor cells for CD68 and CD 163. Negative markers ruled out the other mimics. Considering his age of 97 years, he was not considered to be suitable for surgery or aggressive therapy. HS is an extremely rare neoplasm and it is a diagnosis of exclusion. The key to diagnosis is immunohistochemistry. Molecular genetic studies have reported a few abnormalities and needs to be confirmed.There is no standard protocol for the management of HS due to its rarity.

Pseudomonas aeruginosa persists as a dreaded organism causing increased mortality both in developing and industrialized countries. Published literature elaborates novel rapid molecular diagnostics and strategies for discovering newer antibiotics for this highly resistant organism. It is also an established fact that the primary focus of infection remains unknown in majority of the cases. Unfortunately there exists a paucity of data from outpatient clinics and standalone referral laboratories. Such a system of health care delivery is common in many parts of the world including United Arab Emirates. This article enlists two pediatric clinical cases which elucidate early Pseudomonas diagnosis in the community leading to prompt treatment and recuperation. The role played by referral diagnostic laboratories needs to be discussed in the context of existing guidelines, local epidemiology and healthcare practices. We would like to add a microbiologist’s perspective and emphasize on prompt identification and susceptibility pattern, in a community setting by referral diagnostic laboratories. The relevance of whether a bacteria is pathogenic/colonizer/contaminant need to be understood with clarity which will be helpful during the evolution of the newer guidelines. This article also elaborates on the effective communication between clinicians and laboratory which is the invaluable for any robust health care system.

Urinary tract infections are defined as the spectrum of diseases of the genito urinary tract by micro organisms. The risk of urinary tract infection (UTI) is higher in diabetics and the antibiotic resistance of uropathogens have been changing over the past few years. Hence, the study was undertaken to determine the prevalence of various uropathogens and their antibiotic sensitivity pattern in diabetic patients with UTI. Methods: Clean voided midstream urine was collected, & inoculated on Blood Agar (BA) and McConckey Agar (MA), and incubated at 37OC overnight for visible growth. Results: Out of 120 diabetic patients, 75 patients (30 males and 45 females) were found to have culture positive UTI. The rate of isolation of Klebsiella species (50%) was highest, followed by Escherichia coli (16.6%), Staphylococcus aureus (16.6%), Coagulase negative Staphylococcus (12.5%) and Citrobacter species (4%). All the isolated organisms showed maximum sensitivity to Carbapenems and least susceptibility to Norfloxacin and Nitrofurantoin. Conclusion: High blood glucose is the main cause of UTI among diabetics. Therefore, isolation of pathogens in diabetic patients with UTI is important to initiate appropriate antibiotic therapy and to prevent renal complications

Medicinal plants have played a key role in world health. Plants and their products have been used since time immemorial as principal ingredients of various traditional medicines. It has been the mainstay of many traditional cultures for their low cost and wide accessibility in addition to their preventive and therapeutic value. The aim of this research was to evaluate the antioxidant and antibacterial activity of T. catappa methanolic leaf extract and its fractions. The antioxidant activity was determined using DPPH radical scavenging activity using varied concentrations (31.25-500µg/ml) of different extracts and fractions then 100µl of purified water at absorbance of 515nm using ELISA plate reader. Ascorbic acid was used as a standard. The antibacterial activity was evaluated by determining the MIC and MBC of different fractions at different concentration. The results of the study indicated the presence of major phyto-compounds like alkaloids, steroids, phenolics and saponins. It also showed that the ethyl acetate and n-butanol fractions of the leaf of T. Catappa possess the highest significant scavenging activity against DPPH• (64.02% at 250μg/ml and 62.43% at 500 μg/ml respectively). Moreover, total phenolics concentration equivalent to gallic acid was found to be up to 70 mg/g for the ethyl acetate fraction, which correlated with antioxidant activity. The result of the antibacterial study showed evidence that, the methanol leaf extract of T. Catappa possess antibacterial activity and N. butanol portion has the highest activity. In conclusion this study showed that the methanol extract and fractions of the leaf of T. Catappa have demonstrated significant antioxidant and antibacterial activities but further study is recommended to ascertain the compounds responsible for their antioxidant activity.

Objectives: The aim of this study is to compare two different methods in identifying significant bacteriuria. Materials and Methods: A cross-sectional study was conducted for a period of three months from January to March 2019. Urine samples received to Clinical Microbiology Laboratory were subjected to Standard loop technique and Pour plate technique.104 CFU/ml was considered as significant bacteriuria. Statistical analysis was made by chi-square test. Results: Out of 300 urine samples, 87 samples were shown to have Significant Bacteriuriaby Standard loop technique, 91 samples were shown to have Significant Bacteriuria by Pour plate technique. The Escherichia coli accounts for (30%) of isolates causing Significant Bacteriuria followed by Proteus species (17%), Enterococcus species (16%), and Pseudomonas species (14%). Male preponderance was observed over females. The Pour plate technique was found to be most sensitive method in identifying significant Bacteriuria. Conclusion: The Pour plate technique was observed to be the sensitive method in identifying significant bacteriuria compared to standard loop technique. Escherichia coli showed the highest rate of isolation [1]. Multi-drug resistance is seen in Klebsiella species.